Medical device alert, optimization, personalization, and escalation

ABSTRACT

An alert is used to inform a user that their blood glucose level has dropped below a threshold (e.g., the user is hypoglycemic) or has increased above a threshold (e.g., the user is hyperglycemic). There is a hierarchy of alerts from lowest priority to highest priority. The alert is communicated by a user device (e.g., a mobile device), which is, for example, a smartphone, smart watch, home automation device, or the like. The alert is modified in order to increase the likelihood that the user receives or acknowledges the alert within a minimal amount of time. An intensity level (e.g., a volume) of an alert is modified based on, for example, whether the user has acknowledged a previous alert. A modality or a sensory channel of an alert is changed if an initial alert does fails to elicit a response from the user.

CROSS-REFERENCE

This application is a continuation of U.S. patent application Ser. No.16/268,453, filed Feb. 5, 2019, which is hereby incorporated byreference in its entirety.

BACKGROUND

Devices are used to alert a user during a potential medical emergency.The user may be a person with diabetes (user), and the alert is adiabetes-related alert. For example, the user's device may alert theuser that the user's blood sugar is below a threshold (e.g., the user ishypoglycemic) or above a threshold (e.g., the user is hyperglycemic).

The alert volume at which these devices deliver alerts may be at asuboptimal level given the environment of the user. The alert volume maybe too soft given the environment. For example, the user may be in arelatively loud environment (e.g., a sporting event) where the user maynot hear an alert that would otherwise be audible. Alternatively, thealert volume may be too loud given the environment. For example, theuser may be in an environment where loud noise is discouraged (e.g., amovie theater, church, library, or another location at which loud noisesare discouraged). The user may decrease the volume of the alert ordisable the alert entirely, which may lead to the user missing furtheralerts.

A user may fail to receive or react to these alerts, for example becausethe alert volume is too low to be heard, the user is away from themobile device, or the user is asleep. The user's failure to receive orreact to an alert may lead to negative consequences for the user. Forexample, the user may become hypoglycemic or hyperglycemic. The user'sunresponsiveness to a given alert also causes unnecessary processing ofalerts at the user's device, which results in unnecessary depletion ofbattery power for battery-powered devices and may eventually result intotal battery depletion, which leads to an inability of the device toalert the user of further events.

The user's blood glucose level is monitored by a blood glucose monitor(BGM) or a continuous glucose meter (CGM) that is implanted into orotherwise physically connected to the user. Defects may arise in theseglucose monitoring devices. For example, the sensor may be out ofcalibration, too hot or too cold, or otherwise unable to perform itsfunctions. When alerts from the user's devices are poorly communicated,the user fails to receive alerts indicating the defects with the glucosemonitoring devices, which may cause the user to be unaware of alerts andsubsequently become hypoglycemic or hyperglycemic.

SUMMARY

A user device is implemented to provide diabetes-related alerts to auser. The alerts are used to inform a user that their blood glucoselevel has dropped below a threshold (e.g., the user is hypoglycemic) orhas increased above a threshold (e.g., the user is hyperglycemic). Thealerts are used to inform the user of a problem with a device formonitoring or treating a diabetic condition.

The alert is modified in order to increase the probability that the userreceives and acknowledges the alert within a minimal amount of time.There are multiple types of alerts (e.g., real-time alerts, predictivealerts, or another type of alert). For example, the alert is customizedto the user and to the user's environment. In addition, the alert ismodified in order to reduce the power used by a user device to send thealert. Reducing the power used by the user device to send the alertallows the user device to remain powered for a longer time. The alertsinclude notifications to the user of technical issues with the userdevice or connected devices (e.g., a glucose monitoring device implantedin the user).

An intensity level (e.g., a volume) of an alert is modified based on,for example, whether the user has acknowledged a previous alert. Forexample, an alert is initially presented at a low priority. If the userdoes not acknowledge the alert within a given time period, the alert isrepeated until the user acknowledges the alert. The intensity of thealert is increased by a just-noticeable difference (JND) each time thealert is repeated. The user device records the intensity level at whichthe user acknowledged the alert and adjusts the level of future alertsbased on the recorded level.

The user device adjusts the baseline intensity level of the initialalert or the repeated alerts based on a user-specific criteria. Theuser-specific criteria is an age of the user, a gender of the user, aphysical condition of the user, a mental condition of the user, or thelike. For example, the user may have age-related hearing loss, and thevolume of an auditory alert is increased to offset the hearing loss. Thevolume of any further alerts is further increased by a just-noticeabledifference. If the alert is a visual alert (e.g., flashing lights or avisual notification on the user device), the baseline intensity level ofthe initial alert is increased if, for example, the user has a conditionthat impairs their vision.

A sensory channel of an alert is changed if an initial alert fails toelicit a response from the user. An initial alert is presented in agiven sensory channel (e.g., a visual alert, a haptic alert, an auditoryalert, or the like). If the user does not acknowledge the initial alert,a further alert is presented in a second sensory channel. For example,an initial alert is presented as a haptic signal to the user. Forexample, the user device vibrates for the initial alert. If the userfails to acknowledge the haptic signal, a second alert is presented asan auditory signal to the user. The auditory signal is a tone associatedwith a specific medical condition. Alternatively, the user device calls,texts, or otherwise attempts to contact the user or an emergencycontact. The user device notifies emergency services that the user has amedical emergency and sends the location of the user device to theemergency services.

Different types of alerts within a single sensory channel are used. Forexample, an initial auditory alert is relatively simple (e.g., a beep, aringtone, a notification sound, or any combination thereof. If the userdoes not acknowledge the initial auditory alert, the user devicedelivers a second auditory alert that has a higher priority level and ismore intense. The second auditory alert is, for example, a short-spokenphrase, a piece of music, or the like.

The user device sets an upper limit on an intensity level of an alert.For example, the user device sets a maximum volume for an auditory alertor a brightness maximum for a visual alert. The maximum intensity levelis determined based on the priority level of the alert. For example, ahigher priority alert (e.g., that the user is currently hyper- orhypoglycemic) has a higher intensity level than a lower priority alert(e.g., a daily reminder). If an alert reaches the maximum intensitylevel, the user device delivers any further alerts at the maximumintensity level.

The user device limits the modalities that an alert uses based onpriority level of the alert. For example, the higher priority alert ispresented using auditory, visual, and haptic signals, and a lowerpriority alert is presented using auditory signals. The user devicedelivers an alert in a specific sequence of modalities, multiplemodalities at once, or a sequence of multiple modalities. For example,the initial alert is presented as an auditory signal, a second alert ispresented as an auditory signal and a haptic signal, and a third alertis presented as an auditory signal, a haptic signal, and a visualsignal.

An intensity level of an alert is modified based on an environment inwhich the user is located. For example, the alert is an auditory alert.The user may be in an environment where the ambient noise level is aboveaverage (e.g., a sporting event, party, restaurant, or the like). Thevolume of the alert is increased in order to be audible to the userabove the ambient noise. If the user does not acknowledge the alert, thevolume of repeated alerts is further increased by a JND until the useracknowledges the alert. Alternatively, the user may be in an environmentwhere the ambient noise level is below average (e.g., a library, theuser's home, or the like) or where loud noises are discouraged (e.g., areligious service, wedding, movie theater, or the user's workplace). Thevolume of the alert is decreased in order to avoid startling orembarrassing the user. If the user does not acknowledge the alert, thevolume of repeated alerts is increased above the minimum volume. Thereis a volume threshold that an alert may not exceed. The intensity levelof a non-auditory alert (e.g., a visual alert) is similarly changedbased on the environment.

In order to determine an acceptable intensity level, the user devicesamples a relevant characteristic of the environment. For example, foran auditory alert, the user device uses an internal or connectedmicrophone to sample the ambient noise level of the environment. For avisual alert, the user device uses an internal or connected camera tosample the ambient brightness of the environment. The user device usesinformation from the user's calendar or schedule to determine theappropriate intensity level. For example, the user device has access toan online calendar detailing the user's schedule. If the calendarcontains an entry at the time of the alert, the user device usesinformation from the entry (e.g., the entry title, location, type, orthe like) to determine the appropriate intensity level.

The user device has access to information regarding the location of theuser or the user device, and uses the information regarding the locationto determine the appropriate intensity level. For example, the userdevice has access to GPS data, WIFI data, or other data that indicatesthe location of the user device or the user. The user device uses thelocation information to determine a general categorization for thelocation and adjusts the intensity level of the alert correspondingly.For example, the user device uses GPS data to determine that the userdevice is located in or near a church, and decreases the intensity levelof the alert.

The user device is connected to one or more other devices that are usedto alert the user if the user fails to acknowledge an alert from theuser device (e.g., if the user is away from the user device). Forexample, the user device is connected to the other device via a wirelessconnection (e.g., WIFI, Bluetooth, LTE, or the like). The other deviceis any IoT device (e.g., a smartwatch, a home automation device, or thelike). The other device may be in approximately the same location as theuser device, or the other device may be located remotely from the userdevice. The user device sends a notification to the other device todeliver an alert to the user if the user does not acknowledge an alertfrom the user device. For example, the user device is a smartphone, andsends a notification to a smartwatch worn by the user to deliver analert to the user. The alert presented by the other device is any typeof alert as described herein. The user device uses information about thelocation of the other devices or the user to determine which otherdevice to send the notification to.

In an example embodiment, a first non-audible alert is provided using atleast a first sensory channel on a mobile device associated with a userin response to detection of a triggering event for communicating adiabetes-related alert to the user. The first non-audible alertcomprises an alert message on a display of the mobile device and avibration of the mobile device.

A second non-audible alert is provided using the at least the firstsensory channel on the mobile device associated with the user. Thesecond non-audible alert has a higher priority level than the firstnon-audible alert. The second non-audible alert is provided in responseto an indication of user acknowledgement of the first non-audible alertfailing to be received after the first non-audible alert has beenprovided a predefined number of times. The second non-audible alertcomprises the alert message on the display of the mobile device, avibration of the mobile device, and a flashing LED on the mobile device.

A first audible alert is provided using a second sensory channel on themobile device associated with the user. The first audible alert has ahigher priority level than the second non-audible alert. The firstaudible alert is provided in response to an indication of useracknowledgement of the second non-audible alert failing to be receivedafter the second non-audible alert has been provided a predefined numberof times. The first audible alert comprises the alert message on thedisplay of the mobile device and an audible version of the alert messageread at a first volume level via a speaker of the mobile device using atext-to-speech service.

A second audible alert is provided using the second sensory channel onthe mobile device associated with the user. The second audible alert hasa higher priority level than the first audible alert. The second audiblealert is provided in response to an indication of user acknowledgementof the first audible alert failing to be received after the firstaudible alert has been provided a predefined number of times. The secondaudible alert comprises the alert message on the display of the mobiledevice and an auditory alert notification at a first volume level via aspeaker of the mobile device.

In an example embodiment, the first audible alert is provided at asecond volume level louder than the first volume level of the firstaudible alert. The first audible alert is provided at the second volumelevel in response to the indication of user acknowledgement of the firstaudible alert failing to be received after the first audible alert hasbeen provided and before the first audible alert has been provided thepredefined number of times.

In an example embodiment, the second audible alert is provided at asecond volume level louder than the first volume level of the secondaudible alert. The second audible alert is provided at the second volumelevel in response to the indication of user acknowledgement of thesecond audible alert failing to be received after the second audiblealert has been provided and before the second audible alert has beenprovided the predefined number of times.

In an example embodiment, an external alert is provided from the mobiledevice to an external source in response to the indication of useracknowledgement of the second audible alert failing to be received afterthe second audible alert has been provided the predefined number oftimes. In an example, the external source is a home automation system.

In an example embodiment, a diabetes-related alert is communicated to auser via an audible alert on a mobile device associated with the user.The audible alert is communicated in response to detection of atriggering event for communicating the diabetes-related alert to theuser. A volume level of the audible alert is increased until a maximumvolume level is reached in response to an indication of useracknowledgement of the audible alert failing to be received after apredetermined period of time. One or more diabetes-related alerts isgenerated in an order of a predefined hierarchy of alerts. Thediabetes-related alerts are generated in response to the indication ofuser acknowledgement of the audible alert failing to be received andafter the maximum volume level is reached. The predefined hierarchy ofalerts comprises two or more of: a predefined speech for the one or morediabetes-related alerts that is configured to be sent to a speakerdevice for audible communication to an occupant of a space; a predefinedmessage for the one or more diabetes-related alerts that is configuredto be sent via telecommunication or text message using an alternatedevice to the mobile device; a predefined message for the one or morediabetes-related alerts that is configured to be sent via an instantmessaging service; or a message for the one or more diabetes-relatedalerts that is configured to be sent to provide an alert via a homeautomation system. In an example, the predefined speech includes a nameof the user. A last known location of the mobile device is communicatedto at least one emergency contact or emergency service in response to anindication of user acknowledgement of the predefined hierarchy of alertsfailing to be received after a predefined period of time.

In an example embodiment, a lack of movement of the user is sensed viathe mobile device over a period of time after the detection of thetriggering event. A determination is made that the lack of movementmatches a sleep state or a hypoglycemic state. An emergency service iscontacted in response to the lack of movement matching the hypoglycemicstate.

In an example embodiment, the home automation system comprises adiabetes notification lamp. The message is configured to control thediabetes notification lamp to provide the one or more diabetes-relatedalerts.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a representative environment formonitoring or treating a diabetic condition.

FIG. 2 shows a flowchart of an example process for increasing an alertvolume when a diabetes-related alert is unacknowledged by a user.

FIG. 3 shows a flowchart of an example process for delivering adiabetes-related alert using different modalities.

FIG. 4 shows a flowchart of an example process for delivering adiabetes-related alert using information from a user's calendar and alocation of the user.

FIG. 5 shows an example graphical user interface (GUI) that displayscalendar information used to determine the location of a user.

FIG. 6 shows a flowchart of an example process for providing adiabetes-related alert to a user using different sensory channels.

FIG. 7 is a flowchart of an example process for determining a volumelevel of an alert based on an ambient noise volume level.

FIG. 8 shows a flowchart of an example process for determining a volumelevel of an alert based on user-specific criteria (e.g., an age orgender of a user).

FIG. 9 shows a flowchart of an example process for determining a volumelevel of an alert based on an ambient noise volume level and a hearingability of a user.

FIG. 10 is a block diagram of an example computing device.

FIG. 11 is a block diagram of an example blood glucose monitoringdevice.

FIG. 12 is a block diagram of an example blood glucose measuring (BGM)device.

FIG. 13 is a block diagram illustrating an example of an insulin pump.

DETAILED DESCRIPTION

FIG. 1 is a perspective view of a representative environment formonitoring or treating a diabetic condition. As shown in FIG. 1, a user100 with diabetes uses one or more blood glucose monitoring devices tohelp monitor or treat the diabetic condition. The diabetic conditionincludes a metabolic syndrome, pre-diabetes, type 1 diabetes, type 2diabetes, or gestational diabetes. The user 100 may be in an extremediabetic state, such as hypoglycemia or hyperglycemia, when the bloodglucose level of the user 100 is above or below a threshold bloodglucose level. In the embodiment of FIG. 1, the user 100 uses a bloodglucose monitoring device to monitor blood glucose levels.

As used herein, the term “blood glucose monitoring device” refers to anydevice that detects and reports a level of glucose in the blood of theuser, either through direct measurement of the blood or through anindirect detection process. A blood glucose level is also referred to asa blood sugar level. Examples of blood glucose monitoring devicesinclude, but are not strictly limited to, continuous glucose monitoringdevices, flash glucose monitoring devices, and blood glucose meters thatprovide a single measurement of blood glucose levels from a blood samplein a “spot” monitoring process. FIG. 1 depicts examples of blood glucosemonitoring devices that are described in more detail below.

In some embodiments, the blood glucose monitoring device is a continuousglucose monitor (CGM) 102. The CGM 102 includes a subcutaneous sensorthat is used to sense and monitor the amount of glucose in interstitialfluid of the user 100. The CGM 102 includes a transmitting device thatis located directly over the sensor that wirelessly powers the datatransfer from the sensor. The CGM 102 periodically communicates dataindicating the blood glucose levels of the user 100 to an externaldevice, such as a mobile device 104, for computing or storing the bloodglucose levels of the user 100.

As used herein, the term “mobile device” refers to any mobile electronicdevice that is capable of moving with a user as the user changeslocations. Example mobile devices include mobile phones, smartphones,wearable devices, tablets, laptops, notebook computers, personal digitalassistants (PDAs), and any other mobile electronic device that iscapable of moving with a user. Some embodiments of the mobile deviceincorporate the blood glucose monitor into an integrated device.

Some embodiments of the mobile device 104 operate as a CGM controllerdevice. Though the mobile device 104 is provided as an example of adevice with which the CGM 102 communicates, the CGM 102 may communicatewith other dedicated CGM controller devices for providing similarfunctionality that is described herein for the mobile device 104. TheCGM 102 processes the blood glucose data for providing alerts, or theblood glucose data is processed at the mobile device 104, or other CMGcontroller device, an alert indicator is communicated to the CGM 102.

In some embodiments, the blood glucose monitoring is performed by flashglucose monitoring (FGM). The FGM includes a subcutaneous sensor 103that is used to sense and monitor the amount of glucose in interstitialfluid of the user 100. A separate reader device, such as the mobiledevice 102 or another reader device, receives the blood glucoseinformation from the sensor when the device is within the RF range ofthe sensor 103. The sensor 103 transmits an instantaneous blood glucoselevel or a graphical trend of the blood glucose level to the readerdevice for display.

The user 100 uses a blood glucose meter (BGM) 106 as a blood glucosemonitoring device to monitor blood glucose levels. The BGM 106 includesport 108 that receives a blood glucose measurement strip 110. The user100 deposits a sample of blood on the blood glucose measurement strip110. The BGM 106 analyzes the sample and measure the blood glucose levelin the sample. The blood glucose level measured from the sample isdisplayed on a display 112 of the BGM 106 or communicated to an externaldevice, such as the mobile device 104.

The blood glucose level measured by the BGM 106 or computed using datareceived from the CGM 102 is used to treat the diabetic condition of theuser 100. For example, the user 100 uses an ambulatory non-durableinsulin pump 116 or an ambulatory durable insulin pump 118 to treat thediabetic condition with insulin. The mobile device 104 determines anamount of insulin to be administered to the user 100 and the insulinpump 116, 118 receives instructions from the mobile device 104 todeliver a predetermined amount of insulin to the user 100. The insulinpump 116, 118 receives other information from the mobile device 104,such as mealtime information or exercise information of the user 100.The insulin pump 116, 118 determines the amount of insulin to administerbased on the received information from the mobile device 104. Theinsulin pump 116, 118 communicates information to the mobile device 104.The information communicated to the mobile device 104 includes an amountof insulin delivered to the user 100, corresponding times of delivery,or a pump status (e.g., battery status, insulin status, or anotherstatus of a portion of the pump).

The mobile device 104 communicates with the insulin pump 116, 118, theCGM 102, or the BGM 106 using wired or wireless communications. Themobile device 104, the CGM 102, a CGM controller, the BGM 106, or theinsulin pump 116, 118 are collectively referred to as user devices. Themobile device 104 communicates with the insulin pump 116, 118, the CGM102, or the BGM 106 using the same or different wireless protocols. Forexample, the mobile device 104 communicates with the insulin pump 116,118, the CGM 102, or the BGM 106 using BLUETOOTH®, near fieldcommunication (NFC), THREAD®, WIFI®, ZIGBEE®, WI-MAX®, a cellularcommunication protocol, a proprietary wireless communication protocol,or another radio frequency (RF) communication protocol.

The mobile device 104 receives data and stores data for assisting inmonitoring or treating the diabetic condition. The mobile device 104receives input from the user 104 via a user interface being provided ona display. The mobile device 104 receives input via hard buttons or softbuttons provided on the display.

The mobile device 104 is configured to determine the device's location.For example, the mobile device 104 is able to determine the geolocation(e.g., latitude and longitude) of the device using signals from a globalpositioning system (GPS) or triangulation via cellular communications.The mobile device 104 determines a relative location using an RF beacondevice 126. The RF beacon device 126 communicates a unique identifiervia a short-range wireless communication, such as a BLUETOOTH® lowenergy (BLE) beacon or an NFC beacon. The mobile device 104 receives theRF beacon and perform a lookup in a database (e.g., in information fromthe datastores 124) to determine a relative location associated with theunique identifier. For example, the mobile device 104 determines thatthe RF beacon indicates that the device is in a particular room in ahome or building, on a certain floor in a building, close to apredefined object, or is within the RF range of a beacon associated withanother object or location.

Some embodiments of the mobile device 104 include one or more sensorsfor detecting a relative position of the device or information about theuser 100. The mobile device 104 detects a movement or a change inorientation. Based on the movement or change in orientation (or lackthereof) of the mobile device 104 over a period of time, the mobiledevice 104 detects that the user 100 is standing, sitting, or lyingdown. The mobile device 104 detects that the user 100 is exercising whenthe movement or a change in orientation is greater than a threshold fora period of time. The mobile device 104 detects the heartrate of theuser 100 using a heartrate sensor. Based on the heartrate and themovement of the user 100 over a period of time, the mobile device 104detects whether the user 100 is asleep or awake. The information aboutthe mobile device 104 or the user 100 is used to provide informationabout or treat the diabetic condition.

The mobile device 104 provides information to the user 100 about theuser's diabetic condition. For example, the mobile device 104 providesblood glucose levels, provides meal-related information, providesexercise-related information, generates graphs and other graphical userinterfaces for display, or generates alerts that are provided to theuser 100. For example, the mobile device 104 measures the blood glucoselevel of the user 100 and provide an alert when the blood glucose levelof the user 100 has reached a threshold for an extreme diabetic state(e.g., hypoglycemia or hyperglycemia). The alerts provided by the mobiledevice 104 are audible or non-audible alerts. The non-audible alerts areprovided as a vibration, a flashing of the screen, or a flashing of anLED on the mobile device 104. The alerts also, or alternatively, areprovided by an external device based on a communication from the mobiledevice 104. Some embodiments of the mobile device 104 include anelectric motor for providing on-body vibration alerts or a speaker forproviding audible alerts in response to data indications or triggersidentified in the monitored blood glucose data.

The mobile device 104 communicates with other devices directly via awired communication or a short-range wireless communication (e.g.,WI-FI®, BLUETOOTH®, BLE, NFC, or another suitable short-range wirelesscommunication). The mobile device 104 communicates indirectly withremote computing devices 122 or datastores 124 via a network 120 (e.g.,using a WI-FI® network, a cellular network, a WI-MAX® network, oranother wired or wireless network). The network 120 is a wired orwireless network. The network 120 is used to communicate over theInternet to other devices.

The mobile device 104 communicates with the remote computing devices togenerate user interfaces for display on the mobile device 104, performremote computation, or to otherwise control a remote computing device.For example, the mobile device 104 provides a user interface via anapplication or web browser that is generated at a remote computingdevice 122. The mobile device 104 generates instructions for providingalerts via remote computing devices 122 based on information receivedfrom the user 100, the CGM 102, the BGM 106, or the insulin pump 116,118. Example remote computing devices 122 to which the mobile device 104sends communications for performing alerts include a remote computer(e.g., a server, a laptop, or other computer), an external speaker, anexternal display device (e.g., television, monitor, or another devicehaving an external display), a home automation system, remotetelecommunications devices (e.g., for sending text or voicecommunications to an emergency contact over a telecommunicationsnetwork), or another remote computing device.

The mobile device 104 communicates with the datastores 124 to storeinformation or retrieve information. The information includesinformation related to the user 100, the CGM 102, the BGM 106, or theinsulin pump 116, 118. For example, the mobile device 104 receivestreatment information associated with the user 100 as input or receiveblood glucose information from the CGM 102 or the BGM 106 and send theinformation to the datastores 124 via the network 120. Storedinformation is retrieved from the datastore 124 for treatment of thediabetic condition of the user. For example, the mobile device 104retrieves an amount of insulin delivered to the user 100 orcorresponding times of delivery. The datastores 124 include one or moreremote storage locations, which are collectively referred to as cloudstorage. For example, the datastores 124 store information regarding oneor more personal characteristics of the user 100 (e.g., the user's ageor gender) or one or more alert profiles for an alert.

One or more of the user devices are implemented to providediabetes-related alerts to a user. The alerts are used to inform a userthat their blood glucose level has dropped below a threshold (e.g., theuser is hypoglycemic) or has increased above a threshold (e.g., the useris hyperglycemic). The alerts are also used to inform the user of aproblem with a device for monitoring or treating a diabetic condition.To better ensure that the user receives the alerts regarding the user'sdiabetic condition or the status of the user's devices for monitoring ortreating the diabetic condition, an alert is modified based on userinput, lack of user input, user-specific characteristics, or the userenvironment.

FIG. 2 shows a flowchart of an example process 200 for increasing analert volume when a diabetes-related alert is unacknowledged by a user.The example process 200 is performed by one or more devices, such as oneor more user devices, for example. The process 200 is performed by asingle user device, or distributed across multiple devices.

As illustrated in FIG. 2, a triggering event is detected at 202 forcommunicating a diabetes-related alert to a user. The triggering eventis detected when a blood glucose level of the user is above a high-endthreshold or below a low-end threshold. The alert is generated by a userdevice (e.g., a smartphone, wearable device, a CGM, a CGM controller, aBGM, an insulin pump, a home assistant, or the like) in response to adetection that the user has entered or is entering an extreme diabeticstate (e.g., the user is hypoglycemic or hyperglycemic). For example,the mobile device calculates the blood glucose level of the user basedon data from the CGM, or receive the blood glucose level of the userfrom the BGM, and determine that the blood glucose level is above ahigh-end threshold (e.g., the user is in a hyperglycemic state, or isabout to enter the hyperglycemic state) or below a low-end threshold(e.g., the user is in a hypoglycemic state, or is about to enter thehypoglycemic state). The triggering event is detected when the userdevice receives an indication of a defect or other problem with the userdevice itself or another user device (e.g., the mobile device 104, theCGM 102, a CGM controller, the BGM 106, or the insulin pump 116, 118).For example, the defect or other problem includes a battery level of thedevice being below a threshold, a sensor being out of calibration, orthe like.

At 204, the user device generates the alert. The user device generatesthe alert and provide the alert via an auditory signal or as anotification on a screen of the user device. For example, if the userdevice is a mobile device, the alert is presented by playing a specificsound or tone associated with the alert.

The user device may receive an acknowledgement of the diabetes-relatedalert from the user at 206. For example, the user may tap the screen ofthe user device to acknowledge the alert. The user may acknowledge thealert by saying a word or phrase that is detected by a microphone of theuser device. If the user has acknowledged the alert, the user devicestops the alert and return the volume level of future alerts to adefault setting at 212.

If alert is acknowledged at the user device within a predefined periodof time, the user device determines whether a maximum volume level(e.g., a predefined total volume level) for the alert has been reachedat 208. If the maximum volume level has been reached, the user devicedelivers the alert again at the same volume level at 204. If the maximumvolume has yet to be reached, the user device increases the volume leveldiabetes-related alert at 210 and provide the diabetes-related alert atthe increased volume level at 204.

In some embodiments, the user device increases the volume level of thealert by a just-noticeable difference (JND). A JND is an amount that anintensity level (e.g., a volume level or vibration level) is changed inorder for the difference to be detectable at least half the time. Forexample, the intensity level is a volume level, and a default JND forthe volume level is in a range of approximately 0.2 to 0.4 dB. The JNDamount is modified by the user device, based on, for example,user-specific criteria, the user's response to previous alerts deliveredby the user device, or a condition of the user device. For example, ifthe user device is in a sleep mode, the JND is approximately 15 dBA.Increasing the alert volume by a JND increases the likelihood that auser will acknowledge a subsequent alert while minimizing battery lossfor the user device or noise pollution.

FIG. 3 shows a flowchart of an example process 300 for delivering adiabetes-related alert using different modalities. The example process300 is performed by one or more devices, such as one or more userdevices, for example. The process 300 is performed by a single userdevice, or distributed across multiple devices.

As shown in FIG. 3, the user device detects a triggering event at 302for communicating a diabetes-related alert to a user. The triggeringevent is detected as described herein. A user device delivers the alertat 304. The alert is sent using a hierarchy of progressive alertnotifications. For example, an alert is delivered to a user as anauditory signal via the user device. If the user device does not receivean acknowledgement of the alert, the user device continues to increasethe volume level and repeat the alert until a maximum volume level hasbeen reached (e.g., as shown in FIG. 2). The user device similarlynotifies the user using a hierarchy of non-audible alerts, such asincreased vibrations of the user device.

Referring again to FIG. 3, the user device determines whether the useracknowledged the alert at 306. The user may fail to acknowledge thealert, because, for example, the user is out of range of the userdevice, the user is asleep, the maximum alert volume level is too low tobe heard given ambient noise, or the like. If the user device providesthe diabetes-related alert via a home assistant (e.g., a home automationsystem or home speaker system), the user may be in a location other thanthe user's home. If the user device receives an acknowledgement of thealert, the user device stops the alert at 308.

If the user device fails to receive an acknowledgement of the alertafter the alert has reached a maximum alert intensity or the alert hasbeen presented a predefined number of times, the user device determineswhether an external enhanced alert is allowed at 310. For example, theuser device determines whether an external source is available or hasbeen configured for providing alerts from the user device.

If an external enhanced alert is available, a second alert is deliveredto the user using a different modality than the initial alert. Amodality is, for example, a pre-recorded speech message, an SMS or othertext message, a phone call, a visual alert, an alert provided via a homeautomation system, or the like. The user device selects a modality forthe second alert at 312 and configures a message to be sent to theexternal device for providing the external alert. For example, the userdevice selects a speech alert message as the modality for the secondalert.

In some embodiments, the user device uses information from an integratedaccelerometer/gyroscope or GPS circuit to determine which modalityshould be used for the second alert. For example, the user device is awearable device, and data from the accelerometer indicates that the useris asleep, and thus unlikely to hear a simple auditory alert.Alternatively, data from the GPS circuit indicates that the user is awayfrom home, and thus unlikely to detect an alert provided by a homeassistant.

In some embodiments, the user device forwards the alert to a connectedremote computing device via a wireless network. For example, the remotecomputing device is a virtual assistant. The remote computing device orthe user device then delivers the second alert to the user using theselected modality at 314. For example, the virtual assistant devicedelivers the alert as a speech alert message notifying the user of thealert condition.

The user device determines whether the user acknowledged the secondalert at 316. If the user fails to acknowledge the second alert within apredefined time period or after the alert has been presented apredefined number of times, the user device determines whether eachmodality has been used (e.g., modalities are exhausted) at 318. If thereis at least one modality that is available to the user device, the userdevice selects another modality at 312 and alerts the user using theselected modality. For example, if the user does not acknowledge thesecond alert, the user device calls the user's phone number(s) via atelecommunication network and delivers a pre-recorded alertnotification, sends a predefined text message via a telecommunicationnetwork, or sends a predefined message via an instant messaging serviceor a communication application (e.g., Skype, WhatsApp, iMessage, or thelike) to another computing device, such as a phone or computer.

The user device continues to select different modalities and deliver thealert to the user using the different modalities if the user continuesto fail to acknowledge the alert. For example, the user device sends amessage configured to control a smart home automation system (e.g., ahome assistant), which delivers the alert by changing the state of oneor more objects in the user's home (e.g., flashing lights, moving windowblinds, or the like). For example, the home automation system controls adiabetes notification lamp and instructs the diabetes notification lampto deliver the alert.

In some embodiments, the user device determines the modalities for thealert based on a priority level associated with the triggering event ofthe diabetes-related alert. There is a hierarchy of modalities from alowest priority to a highest priority. The lowest priority modality forthe alert is a least intrusive and the alerts become more intrusiveuntil the highest priority alert. A highest priority modality is alsoselected, and the priority level decreases to a lowest priority modalityafter the alert has been provided for a predefined period of time or apredefined number of times. The priority level of is based on thetriggering event. For example, if the triggering event indicates arelatively minor issue (e.g., the user's blood glucose level is higherthan normal, but still within a safe range), the priority level of thealert is lower than the priority level of an alert when the triggeringevent indicates a relatively major issue (e.g., the user's blood glucoselevel indicates the user is in an extreme diabetic state). The increasedpriority level increases the number of modalities that are used toprovide the alert, the volume level of the alert, or otherwise increasesthe severity of the alert.

If the user device has exhausted the available modalities, the userdevice sends a message to the user's emergency contact or an emergencyservice at 320. The emergency contacts are preselected by the user andthe user device contains contact information for the emergency contacts.The message is, for example, an SMS or other text message, a prerecordedvoice message, or the like. If the user fails to acknowledge the alertwithin a predetermined time period after the emergency contacts havebeen contacted, or if the alert condition is time-sensitive, the userdevice contacts emergency services and directs them to the user's lastknown location at 320.

FIG. 4 shows a flowchart of an example process 400 for delivering adiabetes-related alert using information from a user's calendar and alocation of the user. The example process 400 is performed by one ormore devices, such as one or more user devices, for example. The process400 is performed by a single user device, or distributed across multipledevices.

The user may be in a location or at an event where a modified alertvolume is preferable. For example, the user may be in a location or atan event where certain alerts (e.g., having loud noises) are sociallyinappropriate or otherwise discouraged. Presenting an alert at a defaultvolume level may interrupt the event or embarrass the user. The user maydisable the alert or decrease the volume of future alerts, which maycause the user to miss future alerts. Alternatively, the user may be ina location or at an event where the ambient noise volume level is higherthan normal, which may cause the user to miss an alert at the defaultvolume level. If the alert is provided at a level that is unnoticeableto the user, the battery power of the user device is unnecessarilyreduced, which may cause the user device to lose power and be unable toalert the user of further events.

In some embodiments, the user device determines an appropriate alertprofile for an alert based on information in the user's calendar orgeographic data. As illustrated in FIG. 4, the user device detects atriggering event at 402 for communicating an alert to the user. Inresponse to detecting the triggering event, the user device determineswhether the user has previously given permission to access the user'spersonal calendar. If the user has given permission to access theirpersonal calendar, the user device determines whether there is an eventin the calendar for the current time or within a predefined period oftime at 404. For example, upon detection of a triggering event, the userdevice accesses the user's calendar and determine that there is an eventfor the current time or within a predefined period of time. The calendaris accessed by the user device locally, from a remote datastore, from aremote computing device, or from a calendar service. If there is noevent in the calendar at the current time or within a predefined periodof time, or if the user has not given permission to access the calendar,the user device proceeds to 408.

If there is an event in the calendar at the current time or within apredefined period of time, the user device detects one or more keywordsin the title field of the event or in the location field of the event at406. For example, the event title is “Ravens game” and the eventlocation is “M&T Bank Stadium”. The user device detects the keyword“game” in the title field or the keyword “stadium” in the locationfield. If the location is a street address, the user device attempts tomatch the street address to a known entity (e.g., a business, residence,or other entity) at that street address and detect keywords in the nameof the known entity. The name of the known entity is a friendly name.For example, if the location is the street address “1101 RussellStreet”, the user device determines that the known entity at that streetaddress is “M&T Bank Stadium” and uses the keyword “stadium” for thelocation field.

At 408, the user device determines whether location data (e.g., GPSdata) is available to the user device. Location data may not beavailable to the user device if, for example, the user device is not inrange of a GPS signal, or the user has not given permission to uselocation-based services or access their location. If the location datais unavailable, the user device proceeds to 412. If the location data isavailable, the user device determines one or more keywords for the userlocation based on the location data. For example, the data indicates thelocation of the user device as a set of latitude and longitudecoordinates. The user device uses a location database to match thecoordinates to an address. The user device uses the street address todetermine one or more keywords for a known entity at that address. Forexample, the user device obtains its latitude and longitude coordinatesfrom GPS data, and determines that the street address matching thosecoordinates is “1101 Russell Street.” If the known entity found at thestreet address has one or more metadata fields that are useful tocategorizing the type of event or location at that known entity in itsGPS database information, the user device detects keywords in themetadata fields. For example, known entity “M&T Bank Stadium” at streetaddress “1101 Russell Street” may have one or more metadata fieldsindicating it is used for football events, and the user device detectsthe keyword “football” or “sports” in the metadata fields.

At 412, the user device matches the keywords from the calendar or thegeographic location data to keywords associated with pre-determinedalert profiles. The alert profiles are stored in an alert profiledatabase on the user device, an external device, or an externaldatastore. The alert profiles are associated with one or more keywords.For example, the user device searches available alert profiles that areassociated with the keywords “game,” “stadium,” “football,” or “sports.”

At 414, the user device determines how many keywords from the calendaror the geographic location data matched keywords associated with thealert profiles. If no keywords matched, the user device delivers thealert using a default alert profile at 416 and stops at 422. If one ormore of the keywords matched to one alert profile, the user devicedelivers the alert using the alert profile that matches the keywords at418 and stops at 422. For example, the user device determines that oneor more of the keywords “game,” “stadium,” “football,” and “sports”matched the alert profile “sporting event.” The user device delivers thealert using the alert profile for “sporting event.”

If one or more of the keywords matched to more than one alert profile,the user device delivers the alert using the lowest priority alertprofile that matches the keywords at 420. For example, the user devicedetermines that one or more of the keywords “game,” “stadium,”“football,” or “sports” matched the alert profiles for “sporting event”and “practice.” The user device determines that the alert profile for“practice” is lower priority than the alert profile for “sportingevent.” For example, the “practice” alert profile uses vibration and anauditory signal at a low volume, and the “sporting event” alert profileuses vibration and an auditory signal at a high volume level. The higherpriority alert profile uses more alerts, or is more severe (e.g.,louder) to get the user's attention more quickly during higher prioritytriggering events. The user device delivers the alert using the alertprofile for “practice.” Alternatively, the user indicates a selection ofa global alert type for delivering alerts to the user. The user devicesuse the global alert type to deliver the alert to the user.

In some embodiments, the user device determines whether a useracknowledgement was received in response to the alert using the lowestpriority alert profile at 424. If the user acknowledged the alert, theuser device stops at 422. If the user failed to acknowledge the alert,the user device delivers the alert at the next highest priority alertprofile at 426. For example, if the user failed to acknowledge the alertusing the “practice” alert profile, the user device delivers the alertusing the “sporting event” alert profile.

The user device continues to deliver the alert using remaining matchingalert profiles as long as the user fails to acknowledge the alert. Ifthe user device has delivered the alert using each of the matching alertprofiles, the user device repeats the alert using the highest priorityalert profile. For example, if the user fails to acknowledge the alertusing the “practice” alert profile and the “sporting event” alertprofile, the user device repeatedly delivers the alert using the“sporting event” alert profile until the user acknowledges the alert, oruntil a predefined period of time or number of repetitions of the alert.

A lower priority alert profile is an alert profile that has a quietervolume level or a lower number of sensory channels. A non-auditory alertis lower priority than an auditory alert. For example, an alert thatuses vibration is lower priority than an alert that uses vibration andan auditory signal, and an alert that uses an auditory signal at a lowervolume level is lower priority than an alert that uses an auditorysignal at a higher volume level. Locations or events that have a lowerpriority alert profile include, but are not limited to: a movie theater,an artistic performance, a library, a museum, a religious building orservice, a wedding or funeral, a business meeting, or a practice.Locations or events that have a higher priority alert profile include,but are not limited to: a gathering, a restaurant, the user's home, oran office or workplace. Locations or events that have an even higherpriority alert profile include, but are not limited to: a game or othersporting event, a fair, a concert, a conference, or a market.

FIG. 5 shows an example graphical user interface (GUI) 502 that displayscalendar information used to determine the location of a user. Forexample, the GUI 502 is displayed on user device 504. User device 504 isany user device with a display that is capable of accessing calendarinformation. For example, user device 504 is a smartphone, a wearabledevice, a laptop, a tablet, a BGM, a CGM controller, or the like.

The GUI 502 displays a calendar 506. The calendar 506 is shown includinghours, days, months, and the like. The GUI 502 displays a popup 508 thatdisplays information about a specific calendar event. The informationincludes the event title 510, the event time 512, or the event location514. The user device 504 uses the event time 512 to determine whetherthere is a current event at the time an alert triggering event isdetected and whether the event is occurring in a predefined period oftime. The user device 504 uses the event title 510 or the event location514 to determine keywords for the event. The user device 504 matches thekeywords to one or more alert profiles for presenting the alert asdescribed herein.

For example, the user device 504 detects a triggering event at 1:30 PMon December 16^(th). The user device 504 accesses the user's calendar506 and determines that the user has one event on the calendar 506 forDecember 16^(th). The user device 504 determines from the event time 512that the event is currently occurring, or is occurring in a predefinedperiod of time. The user device 504 detects the keyword “lunch” in theevent title 510 and the keyword “restaurant” in the event location 514.The user device 504 matches the keywords “lunch” or “restaurant” to thealert profile “Restaurant” and delivers the alert using the “Restaurant”alert profile.

FIG. 6 shows a flowchart of an example process 600 for providing adiabetes-related alert to a user using different sensory channels. Theexample process 600 is performed by one or more devices, such as one ormore user devices, for example. The process 600 is performed by a singleuser device, or distributed across multiple devices.

A sensory channel is a visual channel, an auditory channel, a hapticsignal, another sensory channel, or a combination thereof. There are oneor more distinct alert types within a given sensory channel. Forexample, the alert is provided via the visual sensory channel bydisplaying a message on a display of a user device, turning on orflashing an LED on the user device, turning on or flashing a flashlight(e.g., a photo flash) of the user device, controlling another device inthe user's environment (e.g., an LED, window blinds, or a speakerdevice), or otherwise performing a visual control.

In some embodiments, the alert is provided via the auditory channel byplaying an audible alert. The audible alert includes a speech alert thatincludes an audible spoken version of the alert message (e.g., via atext-to-speech service or pre-recorded speech), an auditory alertnotification (e.g., a chime, a tone, a beep, or an alarm) or the like.For example, an alert provided via the auditory channel includes theuser's name. An auditory alert is provided by the user device or byanother device in the user's environment (e.g., earphones, a speakerdevice, a home automation device, an alarm system, or the like).

There is a hierarchy of sensory channels from a lowest priority to ahighest priority and a similar hierarchy of alert types within a singlesensory channel. For example, a haptic channel is lower priority than avisual channel, and a visual channel is lower priority than an auditorysignal. A hierarchy of sensory channels from lowest priority to highestpriority is haptic, visual, and auditory, though the levels of prioritymay be different.

Within each sensory channel, there is a priority level associated witheach type of alert. For example, within the visual channel, an alertpresented on a display of the user device is lower priority thanflashing an LED of the user device. Within the auditory channel, aspeech alert is lower priority than an auditory alert notification. Anauditory alert at a lower volume is lower priority than an auditoryalert at a higher volume.

In some embodiments, an alert initially has a lower priority level, andis delivered using a sensory channel and alert type commensurate withthe lower priority level. If the user fails to acknowledge the initialalert, the priority level of the alert increases. As the priority levelof an alert increases, the intensity of the alert within a sensorychannel increases (e.g., a volume of an auditory alert is increased, thevibration increases, the brightness/flashing of a display or LEDincreases), a combination of alert types within a sensory channel ischanged (e.g., a flashing LED is used in addition to an alert message ona display), another higher priority sensory channel is used (e.g., anauditory alert is used instead of a visual alert), or a combination ofsensory channels is changed (e.g., a sensory channel is added). Thepriority level of the alert further increases each time the user failsto acknowledge the alert at a given priority level.

At 602, the user device detects a triggering event for communicating analert to the user. The triggering event is detected as described herein.The user device selects one or more sensory channels for the alertnotification at 604. If there are multiple alert types within theselected sensory channels, the user device selects one or more alerttypes. The user device selects a lower priority sensory channel or alower priority alert type for initial presentation of an alert. The userdevice selects successively higher priority sensory channels or alerttypes for subsequent deliveries of the alert. The user device deliversthe alert to the user using the selected sensory channel(s) and alerttype(s) at 606. For example, the initial alert is presented using afirst non-audible alert on the user device, such as a vibration of theuser device or an onscreen alert notification (e.g., an alert message)on the display of the user device.

At 608, the user device determines whether a user acknowledgement isreceived for the alert. If the user acknowledged the alert, the userdevice stops at 610. If the user does not acknowledge the alert, theuser device determines at 612 whether the alert has been delivered apre-defined number of times, or for a predefined period of time, usingthe selected sensory channel(s). If the alert has failed to be deliveredthe pre-defined number of times using the selected sensory channel(s),the user device increases the priority of the alert or selects adifferent alert type at 614. Lower priority alerts are a lower intensitylevel than higher priority alerts. The different alert type is used as areplacement for, or in addition to, the initial alert type. Thedifferent alert type has a higher priority (e.g., is less discreet) thanthe initial alert type. The user device delivers the alert using thehigher priority alert (e.g., having increased intensity) at the selectedalert type at 606. For example, the user device delivers the alert byproviding a second non-audible alert having a higher priority than thefirst non-audible alert, such as by flashing an LED of the user devicein addition to vibrating the user device and displaying the on-screenalert. The priority is increased by providing additional alerts.

If the alert has been delivered the pre-determined number of times usingthe selected sensory channels or for a predefined period of time, theuser device determines whether each sensory channel has been used by theuser device to deliver the alert at 616. If one or more sensory channelshas not been used, the user device selects a different sensory channelto deliver the alert at 604. The different sensory channel is used as areplacement for or in addition to the initial sensory channel. Thedifferent sensory channel has a higher priority (e.g., is less discreet)than the initial sensory channel. For example, the user device selectsan auditory channel to deliver the alert in addition to the hapticchannel or the visual channel. For example, if the user fails toacknowledge the second non-audible alert, the user device delivers thealert at 606 via the auditory channel. The user device delivers thealert by providing a first audible alert having a higher priority thanthe second non-audible alert. For example, the user device delivers thefirst audible alert by providing an audible version of the alert messageread at a first volume level via a speaker of the user device using atext-to-speech service in addition to displaying the on-screen alert andvibrating the user device. The alert message is pre-recorded andincludes the user's name.

The user device continues to increase the intensity of the alert orchange the alert type at 614 if the user device determines that the userdid not acknowledge the alert at 608 and that the alert has beendelivered the pre-defined number of times at 612. If the user fails torespond to the first audible alert, the user device delivers the alertby providing a second audible alert having a higher priority than thefirst audible alert. For example, the user device delivers the secondaudible alert by providing an auditory alert notification at a firstvolume level via a speaker of the user device in addition to displayingthe on-screen alert or vibrating the user device. If the user fails toacknowledge the second audible alert, the priority level of the alert isincreased by, for example, providing additional alert types or byincreasing the volume level of the alert. The intensity level of thealert continues to increase until the user acknowledges the alert.

If the alert has been delivered the pre-defined number of times usingthe selected sensory channels and each sensory channel has been used todeliver the alert, the user device determines whether external alertsare configured. If external alerts are configured, the user deviceforwards the alert to an external alert system, which delivers the alertas described herein. If external alerts are not configured, the userdevice continues to deliver the alert using the lowest priority sensorychannel(s) and alert type(s).

In some embodiments, the user device determines that one or more sensorychannels are unavailable based on, for example, a characteristic of theuser, a time of day, or the like. For example, if the user is deaf orotherwise has hearing problems, the user device determines that theauditory channel is unavailable for delivering the alert. If the time ofday indicates that the user is most likely asleep, the user devicedetermines that the user is unlikely to acknowledge an alert sent usinga visual channel, and determines that the visual channel is unavailablefor delivering the alert. Similarly, the user device determines that theuser is unlikely to acknowledge one or more alert types within a sensorychannel, and determines that the alert types are unavailable fordelivering the alert.

FIG. 7 is a flowchart of an example process 700 for determining a volumelevel of an alert based on an ambient noise volume level. The exampleprocess 700 is performed by one or more devices, such as one or moreuser devices, for example. The process 700 is performed by a single userdevice, or distributed across multiple devices.

At 702, the user device detects a triggering event for communicating analert to the user. The alert is an auditory signal. At 704, the userdevice applies a previously-determined volume level to the alert. Thepreviously-determined volume level is customized to the user based on,for example, the user's gender or age. The previously-determined alertvolume level, taking into account the age and gender of the user, is,for example, 60 dBA. The user device samples an ambient noise volumelevel at 706 using a microphone of the user device. The user devicesamples the ambient noise volume level by testing a sound pressurelevel, which is measured in dBA. The user device samples the ambientnoise volume level using a microphone and determines that the ambientnoise volume level is, for example, approximately 55 dBA.

The user device determines whether the ambient noise volume level ishigher than the previously-determined volume level at 708. If theambient noise volume level is not higher than (e.g., less than or equalto) the previously-determined volume level, the user device adds apredetermined amount to the previously-determined volume level anddeliver the alert using the increased volume level at 710. Thepredetermined amount to be added to the alert volume is, for example, 10dBA. For example, if the previously-determined alert volume level is 60dBA and the ambient noise volume level is 55 dBA, the user device adds10 dBA to the previously-determined volume level and deliver the alertat 70 dBA.

If the ambient noise volume level is higher than thepreviously-determined volume level, the user device adds a predeterminedamount to the ambient noise volume level and deliver the alert at theincreased volume level at 712. For example, if the ambient noise levelis 75 dBA and the predetermined amount is 10 dBA, the user devicedelivers the alert at 85 dBA.

At 714, the user device determines whether the user acknowledged thealert. If the user acknowledged the alert, the user device stops thealert and return the volume level setting of future alerts to a defaultsetting at 716. The default setting is the previously-determined volumelevel. If the user did not acknowledge the alert, the user devicedetermines whether a maximum volume level has been reached at 718. Ifthe maximum volume level has been reached, the user device repeats thealert at the maximum volume level at 720, and returns to 714.

If the maximum volume level has not been reached, the user deviceincreases the volume level of the alert, repeats the alert at 722, andreturns to 714. For example, if the user does not acknowledge an initial75 dBA alert, the user device increases the volume of the alert by apreviously-determined amount (e.g., 5 dBA) and delivers the alert at theupdated volume level (e.g., 80 dBA). If the user continues to fail toacknowledge the alert, the user device continues to increase the volumeof the alert by the predetermined amount until reaching the maximumvolume level. For example, if the maximum volume level of the alert is100 dBA, the user device delivers an initial alert at 75 dBA, followedby 80 dBA, 85 dBA, 90 dBA, 95 dBA, and 100 dBA. The user devicecontinues to deliver the alert at the maximum volume level if the usercontinues to fail to acknowledge the alert.

FIG. 8 shows a flowchart of an example process 800 for determining avolume level of an alert based on user-specific criteria (e.g., an ageor gender of a user). The example process 800 is performed by one ormore devices, such as one or more user devices, for example. The process800 is performed by a single user device, or distributed across multipledevices.

The user's ability to detect an alert may be decreased because ofage-related sensory loss. For example, an older user is less likely thana younger user to detect an auditory alert at a given volume. Similarly,an older user is less likely than a younger user to detect and read anon-screen alert at a given brightness. In addition, a user's gender mayaffect how their sensory loss progresses with age. For example, men mayexperience hearing problems beginning earlier than women, and hearingloss may progress faster in men than in women. Customizing an alertbased on a user's age or gender makes it more likely that the user willdetect the alert, and therefore allows the user to correct the conditionthat caused the alert earlier. This prevents unnecessary battery lossfor the user device by providing alerts that are undetectable to theuser.

At 802, an application setup is executed on the user device (e.g., whenthe application is opened for the first time or at later configuration).The application interacts with the user device to detect alertconditions and deliver alerts to the user. At 804, the user devicedetermines whether the user's age (e.g., or birthdate) or gender areavailable to the application. For example, the age or gender isavailable locally, via a datastore, via user input, or via a remotecomputing device (e.g., social media portal accessible on a remoteserver, government web portal accessible on a remote server, or anotherremote device from which age and gender information is accessed).

The user may enter their age or gender into the application. Forexample, the user may input that they are male and 59 years old.Alternatively, the user device has access to a social media profile ofthe user (e.g., Facebook, AppleID, a contact card for the user, a HealthApp, or the like) that includes the user's age or gender. The user inputor social media profile may provide the user's birthdate, and the userdevice calculates the user's age from the user's birthdate and thepresent date. For example, if the user enters the birthdate May 12, 1959into the app and the present date is Jan. 1, 2019, the app determinesthat the user is 59 years old. The profile may have a profile photo ofthe user, and the user device determines the user's age or gender (e.g.,using a machine learning algorithm) using imaging analysis based on theprofile photo. The algorithm or imaging analysis compares portions ofthe profile photo of the user or features in the profile photo of theuser with predefined images for which age information is known ordetermined. For example, the algorithm or imaging analysis identifiesfacial features (e.g., pupils, nose, nose tip, mouth, eyebrows, lips, orother features) and compares the features to the features in the photosfor which the age information is known or determined. When machinelearning algorithms are employed, a different model is built todetermine gender and age. The algorithm looks at quantifiable featuresin the photos and uses a regression model to model the resulting ages.

If both the user's age and the user's gender are available to the userdevice, the user device stores the user's age and gender for future useat 812. The user device updates the user's age as the user's ageincreases with time. For example, if the user device has the user'sbirthdate, the user device increments the user's age every year on theirbirthday. If the user device has the user's age but not their birthdate,the user device increments the user's age on, for example, January 1 ofevery year.

If one or more of the user's age or gender is unavailable, the userdevice determines whether images of the user are available to the userdevice at 806. For example, the user device determines whether it hasaccess to a camera roll of the user device, and whether there are anyimages (e.g., selfies) of the user within the camera roll. The userdevice determines that a most commonly-occurring face in the camera rollis the user's face, or the user is indicated in metadata associated withthe image.

If there are no pictures of the user in the camera roll, or if the userdevice does not have access to the camera roll, the user device appliesa default non-customized volume level (e.g., 70 dBA) to any futurealerts at 808 and proceeds to determine whether the user wishes to testthe default volume level at 816. If there are images of the useravailable to the user device, the user device performs an imaginganalysis on the images of the user at 810 to estimate the age or genderof the user. The user device stores the user's estimated age or genderfor future use at 812 and uses the age and gender to select a customizedalert level (e.g., 80 dBA) at 814. For example, the user device sets thecustomized alert level to be higher than the default volume level if theuser is older than average.

At 816, the user device determines whether the user wishes to test theselected alert level. If the user wishes to test the selected alertlevel, the user device presents a hearing threshold test to the user at818. For example, the hearing threshold test is used to determine theuser's absolute hearing threshold (e.g., a minimum amount of soundsstimulation required for the user to detect the sound stimulus 50percent of the time). The hearing test includes instructing the user tosit in a quiet area, presenting gradually increasing (e.g., ordecreasing) alert sounds at one or more frequencies and instructing theuser to respond when the user hears the alert (e.g., or stops hearingthe alert). The selected alert level is modified based on the results ofthe hearing test. For example, if the user's absolute hearing thresholdis 85 dBA at 5000 Hz at an ambient noise level of 70 dBA, the userdevice modifies the selected alert volume level to have a baseline of 85dBA.

FIG. 9 shows a flowchart of an example process 900 for determining avolume level of an alert based on an ambient noise volume level and ahearing ability of a user. The example process 900 is performed by oneor more devices, such as one or more user devices, for example. Theprocess 900 is performed by a single user device, or distributed acrossmultiple devices.

At 902, the user device detects a triggering event for communicating analert to the user. At 904, a hearing ability of the user is estimated.The hearing ability is estimated based on user-specific criteria (e.g.,an age or gender of the user, a physical condition of the user, a mentalcondition of the user, or the like). For example, the user deviceestimates the hearing ability of the user to be lower if the user isolder than average or if the user has hearing impairment. The user's ageor gender is determined as described for FIG. 8.

Referring again to FIG. 9, the user device identifies a predefinedvolume level based on the user's estimated hearing ability at 906. Ifthe user's hearing ability is estimated to be lower than average, theuser device identifies a predefined volume level that is higher than abaseline volume level. For example, the baseline volume level is 60 dBA,and the identified volume level is 70 dBA.

The user device samples an ambient noise volume level at 908 using amicrophone of the user device. The user device samples the ambient noisevolume level by testing a sound pressure level, which is measured indBA. The user device samples the ambient noise volume level using amicrophone and determines that the ambient noise volume level is, forexample, approximately 60 dBA.

The user device determines whether the ambient noise volume level ishigher than the predefined volume level at 910. If the ambient noisevolume level is not higher than (e.g., less than or equal to) thepredefined volume level, the user device adds a predetermined amount tothe predefined volume level and set the alert volume to be the increasedvolume level at 912. The predetermined amount to be added to thepredefined volume level is, for example, 10 dBA. For example, if thepredefined volume level is 70 dBA and the ambient noise volume level is60 dBA, the user device adds 10 dBA to the predefined volume level andset the alert volume to be 80 dBA.

If the ambient noise volume level is higher than the identified volumelevel, the user device adds a predetermined amount to the ambient noisevolume level and set the alert volume to be the increased volume levelat 914. For example, if the predefined volume level is 70 dBA and theambient noise level is 75 dBA, the user device adds 10 dBA to theambient noise level and set the alert volume to be 85 dBA.

At 916, the user device delivers the alert to the user at the set alertvolume. At 918, the user device determines whether the user acknowledgedthe alert. If the user acknowledged the alert, the user device stops thealert and returns the volume level setting of future alerts to a defaultsetting at 920. The default setting is the predefined volume level.

If the user did not acknowledge the alert, the user device increases thevolume level of the alert by a just-noticeable difference (JND) at 922.A JND is an amount that an intensity level (e.g., a volume level) ischanged in order for the difference to be detectable at least half thetime. For example, the intensity level is a volume level, and a defaultJND for the volume level is in a range of approximately 0.2 to 0.4 dB.The JND amount is modified by the user device, based on, for example,the user-specific criteria, the user's response to previous alertsdelivered by the user device, or a condition of the user device. Forexample, if the user device is in a sleep mode, the JND is approximately15 dBA. Increasing the alert volume by a JND increases the likelihoodthat a user will acknowledge a subsequent alert while minimizing batteryloss for the user device and noise pollution.

The user device sets the alert volume to the increased volume level anddeliver the alert at 916. For example, if the initial alert volume was80 dBA and the JND is 0.5 dBA, the user device delivers a second alertat 80.5 dBA. The user device continues to increase the alert volume by aJND and delivers the alert using the increased alert volume until theuser acknowledges the alert or a maximum volume is reached. For example,if the maximum volume level of the alert is 100 dBA, the user devicedelivers the alert at increments of 0.5 dBA until the alert volumereaches 100 dBA. The user device continues to deliver the alert at themaximum volume level if the user continues to fail to acknowledge thealert. The user device may receive an indication from a second userassociated with a healthcare provider. The indications indicate that theuser device prevents the user from changing the volume level. Forexample, the indication indicates that the user device disables a changeto control of the volume level by the user. The user device, uponreceipt of the indication, disallows the user from preventing the volumelevel from continuing to increase until the maximum volume (e.g., apredefined total volume level) is met.

FIG. 10 is a block diagram of an example computing device 1000. Thecomputing device is a mobile computing device, such as a tablet, acellular phone, a wearable device, a CGM controller device, or anothercomputing device, for example. As shown in FIG. 10, the computing device1000 includes a processor 1002 for controlling the functionality of thecomputing device 1000. The processor 1002 includes one or more circuits,such as general-purpose processors, special purpose processors,conventional processors, digital signal processors (DSPs),microprocessors, integrated circuits, a programmable logic device (PLD),application specific integrated circuits (ASICs), or the like. Theprocessor 1002 performs signal coding, data processing, power control,image processing, input/output processing, or any other functionalitythat enables the computing device 1000 to perform as described herein.

The processor 1002 stores information in or retrieve information fromthe memory 1016. The memory 1016 includes a non-removable memory or aremovable memory. The non-removable memory may include random-accessmemory (RAM), read-only memory (ROM), a hard disk, or any other type ofnon-removable memory storage. The removable memory may include asubscriber identity module (SIM) card, a memory stick, a memory card(e.g., a digital camera memory card), or any other type of removablememory. The processor 1002 accesses the memory 1016 for executableinstructions or other information that is used by the computing device1000.

The computing device 1000 includes a camera 1006 that is incommunication with the processor 1002. The camera 1006 is a digitalcamera or other optical device capable of generating images or videos(e.g., image sequences) for being captured at the computing device 1000.The camera 1006 includes a lighting device capable of flashing to inresponse to signals from the processor 1002. The lighting device flashesto provide alerts via the camera 1006.

The computing device 1000 includes one or more communication circuits1018. The processor 1002 is in electrical communication with thecommunication circuit 1018 for sending or receiving information. Thecommunication circuit 1018 is capable of performing wired or wirelesscommunications. For example, the communication circuit 1018 includes oneor more radio frequency (RF) transceivers for transmitting and receivingRF signals (e.g., BLUETOOTH®, near field communication (NFC), WIFI®,WI-MAX®, cellular, or other suitable wireless transceivers) via anantenna, or other communications module capable of performing wirelesscommunications. One or more communication circuits 1018 are capable ofperforming infrared (IR) communications.

The processor 1002 is in electrical communication with a keypad 1024 forproviding input to the processor 1002. The keypad 1024 includes one ormore keys for receiving input from a user. The keypad 1024 includes hardor soft keys for which the function of the keys may change as a userperforms selections.

Other input into the processor 1002 is provided by one or more sensors1026. The sensors 1026 includes a motion sensor, a proximity sensor, aheartrate monitoring sensor, an accelerometer, a gyroscope, or anothersensor on the computing device. The motion sensor transmits infraredsignals or use image processing to sense movement. The proximity sensortransmits infrared signals to detect when an object is within apredefined proximity. The heartrate monitoring sensor implementsphotoplethysmography to detect the amount of blood flow in the user. Theheartrate monitoring sensor includes one or more LED or photodiodes todetect the amount of blood flow in the user. The heartrate monitoringsensor implements infrared technology to detect the amount of blood flowin the user. The heartrate monitoring sensor takes an electrocardiogram(ECG) and detects information about the user's heartrate from the ECG.The accelerometer measures the non-gravitational acceleration of thecomputing device 1000 in a given direction. The accelerometer respondsto vibrations associated with movement in a given direction. Themeasurements from the accelerometer are used by the processor 1002 todetermine the magnitude or direction of the relative movement of thecomputing device 1000, or the user's relative position (e.g., standing,sitting, or lying down). The gyroscope is used to determine theorientation of the computing device 1000.

The processor 1002 is in electrical communication with or generateimages on a display 1020 for providing information to a user. Thecommunication between the display 1020 and the processor 1002 is atwo-way communication, as the display 1020 includes a touch screenmodule capable of receiving information from a user and providing suchinformation to the processor 1002. For example, the display 1020provides soft buttons for selection by a user that are recognized by thetouch screen module and provided to the processor 1002 as input.

The processor 1002 is in electrical communication with or control aspeaker 1008. The speaker 1008 provides an audible sound (e.g., tone,beep, or buzz) in response to a triggering event detected by theprocessor 1002.

The computing device 1000 includes an electric motor 1010 that is inelectrical communication with or controlled by the processor 1002. Theelectric motor 1010 rotates and causes the computing device 1000 tovibrate (e.g., to indicate an alert) in response to a triggering eventdetected by the processor 1002. The electric motor 1010 provides analert to supplement the audible alarm or replace the audible alarmprovided by the speaker 1008.

The processor 1002 is in electrical communication with or receiveinformation from a microphone 1014. For example, the processor 1002receives audio signals via the microphone 1014.

The computing device 1000 includes a global positioning system (GPS)circuit 1004. The GPS circuit 1004 is capable of receiving GPSinformation. The processor 1002 is capable of determining the GPScoordinates (e.g., latitude and longitude) of the computing device 1000based on the GPS information received via the GPS circuit.

The computing device 1000 includes a visual indicator, such as one ormore one or more light-emitting diodes (LEDs) 1012. One or more LEDs1012 are illuminated or flashed to provide an alert or communicate otherinformation to the user (e.g., low battery or turning on of the device).

FIG. 11 is a block diagram of an example blood glucose monitoring device1100. The blood glucose monitoring device 1100 is a CGM or FGM, forexample. The blood glucose monitoring device 1100 includes asubcutaneous sensor 1126 that is used to sense and monitor the amount ofglucose in interstitial fluid of the user. Data is transmitted from thesensor 1126 to a transmitting device 1104. When the blood glucosemonitoring device 1100 is a CGM, the transmitting device 1104 is locateddirectly over the sensor 1126 and wirelessly powers the data transferfrom the sensor 1126 via power supply 1120. When the blood glucosemonitoring device 1100 is an FGM, the transmitting device 1104 is amobile device or other reader device that instantaneously receives theblood glucose information from the sensor 1126 when the device is withinthe RF range of the sensor 1126.

The transmitting device 1104 receives data communications from thesensor 1126 via a communication circuit 1118. The communication circuit1118 is in electrical communication with a processor 1102. The processor1102 includes one or more circuits, such as general-purpose processors,special purpose processors, conventional processors, digital signalprocessors (DSPs), microprocessors, integrated circuits, a programmablelogic device (PLD), application specific integrated circuits (ASICs), orthe like. The processor 1102 performs signal coding, data processing,power control, input/output processing, or any other functionality thatenables the transmitting device 1104 to perform as described herein.

The transmitting device 1104 includes another communication circuit 1116for communicating with other devices. The processor 1102 is inelectrical communication with the communication circuit 1116 for sendingor receiving information. The communication circuits 1116, 1118 arecapable of performing wired or wireless communications. For example, thecommunication circuits 1116, 1118 includes one or more radio frequency(RF) transceivers for transmitting and receiving RF signals (e.g.,BLUETOOTH®, near field communication (NFC), WIFI®, WI-MAX®, cellular, orother suitable RF signals) via an antenna, or other communicationsmodule capable of performing wireless communications. The communicationcircuits 1116, 1118 communicate using the same RF protocol or adifferent RF protocol.

The processor 1102 stores information in or retrieves information fromthe memory 1112. The memory 1112 includes a non-removable memory or aremovable memory. The non-removable memory includes random-access memory(RAM), read-only memory (ROM), a hard disk, or any other type ofnon-removable memory storage. The removable memory includes a subscriberidentity module (SIM) card, a memory stick, a memory card (e.g., adigital camera memory card), or any other type of removable memory. Theprocessor 1102 accesses the memory 1112 for executable instructions orother information that is used by the transmitting device 1104. Theprocessor 1102 is in electrical communication with a one or more inputkeys 1124 for providing input to the processor 1102.

The processor 1102 is in electrical communication with or controls aspeaker 1114. The speaker 1114 provides an audible sound (e.g., tone,beep, or buzz) in response to a triggering event detected by theprocessor 1102.

The blood glucose monitoring device 1100 includes an electric motor 1110that is in electrical communication with or controlled by the processor1102. The electric motor 1110 rotates and causes the blood glucosemonitoring device 1100 to vibrate (e.g., to indicate an alert) inresponse to a triggering event detected by the processor 1102. Theelectric motor 1110 provides an alert to supplement the audible alarm orreplace the audible alarm provided by the speaker 1114.

FIG. 12 is a block diagram of an example blood glucose measuring (BGM)device 1200. As shown in FIG. 12, the BGM device 1200 includes aprocessor 1202 for controlling the functionality of the BGM device 1200.In various embodiments, the processor 1202 includes one or more digitallogic devices, such as general-purpose processors, special purposeprocessors, digital signal processors (DSPs), microprocessors,integrated circuits, programmable logic devices (PLDs), applicationspecific integrated circuits (ASICs), and any other suitable digitallogic device. The processor 1202 performs signal coding, dataprocessing, power control, image processing, input/output processing, orany other functionality that enables the BGM device 1200 to perform asdescribed herein.

The processor 1202 stores information in or retrieve information fromthe memory 1216. The memory 1216 includes a non-removable memory or aremovable memory. The non-removable memory includes random-access memory(RAM), read-only memory (ROM), a hard disk, or any other type ofnon-removable memory storage. The removable memory includes a subscriberidentity module (SIM) card, a memory stick, a memory card (e.g., adigital camera memory card), or any other type of removable memory. Theprocessor 1202 accesses the memory 1216 for executable instructions orother information that is used by the BGM device 1200.

The BGM device 1200 includes one or more communication circuits 1218.The processor 1202 is in electrical communication with the communicationcircuit 1218 for sending or receiving information. The communicationcircuit 1218 is capable of performing wired or wireless communications.For example, the communication circuit 1218 includes one or more radiofrequency (RF) transceivers for transmitting and receiving RF signals(e.g., BLUETOOTH®, near field communication (NFC), WIFI®, WI-MAX®,cellular, or other suitable RF signals) via an antenna, or othercommunications module capable of performing wireless communications. Oneor more communication circuits 1218 are capable of performing infrared(IR) communications.

The processor 1202 is in electrical communication with a keypad 1224 forproviding input to the processor 1202. The keypad 1224 includes one ormore keys for receiving input from a user. The keypad 1224 includes hardor soft keys for which the function of the keys may change as a userperforms selections.

Other input into the processor 1202 is provided by the BGM sensor module1204. The BGM sensor module 1204 includes a blood glucose measuringengine that analyzes blood samples provided by a patient on a bloodglucose measurement strip and measures the amount of blood glucose inthe samples.

The processor 1202 is in electrical communication with or generateimages on a display 1206 for providing information to a user. Thecommunication between the display 1206 and the processor 1202 is atwo-way communication, as the display 1206 includes a touch screenmodule capable of receiving information from a user and providing suchinformation to the processor 1202. For example, the display 1206provides soft buttons for selection by a user that are recognized by thetouch screen module and provided to the processor 1202 as input.

The processor 1202 is in electrical communication with or control aspeaker 1208. The speaker 1208 provides an audible sound (e.g., tone,beep, or buzz) in response to a triggering event detected by theprocessor 1202.

The BGM device 1200 includes an electric motor 1210 that is inelectrical communication with or controlled by the processor 1202. Theelectric motor 1210 rotates and causes the BGM device 1200 to vibrate(e.g., to indicate an alert) in response to a triggering event detectedby the processor 1202. The electric motor 1210 provides an alert tosupplement the audible alarm or replace the audible alarm provided bythe speaker 1208.

The processor 1202 is in electrical communication with or receiveinformation from a microphone 1222. For example, the processor 1202receives audio signals via the microphone 1222.

The BGM device 1200 includes a visual indicator, such as one or more oneor more light-emitting diodes (LEDs) 1228. One or more LEDs 1228 areilluminated or flashed to provide an alert or communicate otherinformation to the user (e.g., low battery or turning on of the device).

FIG. 13 is a block diagram illustrating an example of an insulin pump1300. As shown in FIG. 13, the insulin pump 1300 includes a processor1302. The processor 1302 includes one or more circuits, such asgeneral-purpose processors, special purpose processors, conventionalprocessors, digital signal processors (DSPs), microprocessors,integrated circuits, a programmable logic device (PLD), applicationspecific integrated circuits (ASICs), or the like. The processor 1302performs signal coding, data processing, power control, imageprocessing, input/output processing, or any other functionality thatenables the insulin pump 1300 to perform as described herein.

In the embodiment of FIG. 13, the processor 1302 is in electricalcommunication with or control a pump motor 1304 in the insulin pump1300. The pump motor 1304 drives a drive unit 1312 that pushes a plungermechanism 1314. The plunger mechanism 1314 ejects insulin from aninsulin cartridge (not shown). The insulin cartridge includes a supplyof insulin for delivery to a user.

The processor 1302 is in electrical communication with or generateimages on a display 1306 for providing information to a user. Thecommunication between the display 1306 and the processor 1302 is atwo-way communication, as the display 1306 includes a touch screenmodule capable of receiving information from a user and providing suchinformation to the processor 1302. For example, the display 1306provides soft buttons for selection by a user that are recognized by thetouch screen module and provided to the processor 1302 as input.

The processor 1302 is in electrical communication with or control aspeaker 1308. The speaker 1308 provides an audible sound (e.g., tone,beep, or buzz) in response to a triggering event detected by theprocessor 1302.

The insulin pump 1300 includes an electric motor 1310 that is inelectrical communication with or controlled by the processor 1302. Theelectric motor 1310 rotates and causes the insulin pump to vibrate(e.g., to indicate an alert) in response to a triggering event detectedby the processor 1302. The electric motor 1310 provides an alert tosupplement the audible alarm or replace the audible alarm provided bythe speaker 1308.

The processor 1302 is in electrical communication with a memory 1316.The processor stores information in or retrieves information from thememory 1316. The memory 1316 includes a non-removable memory or aremovable memory for storing computer-readable media. The non-removablememory includes random-access memory (RAM), read-only memory (ROM), ahard disk, or any other type of non-removable memory storage. Theremovable memory includes a subscriber identity module (SIM) card, amemory stick, a memory card (e.g., a digital camera memory card), or anyother type of removable memory. The processor 1302 accesses the memory1316 for executable instructions or other information that is used bythe insulin pump 1300.

The insulin pump 1300 includes a communication circuit 1318. Theprocessor 1302 is in electrical communication with the communicationcircuit 1318 for sending or receiving information. The communicationcircuit 1318 is capable of performing wired or wireless communications.For example, the wireless communications circuit 1318 includes a radiofrequency (RF) transceiver for transmitting and receiving RF signals(e.g., BLUETOOTH®, near field communication (NFC), WIFI®, WI-MAX®,cellular, or other suitable RF signals) via an antenna, or othercommunications module capable of performing wireless communications. Thecommunication circuit 1318 is capable of performing infrared (IR)communications.

The processor 1302 is in electrical communication with a keypad 1324 forproviding input to the processor 1302. The keypad 1324 includes one ormore keys for receiving input from a user. The keypad 1324 includes hardor soft keys for which the function of the keys may change as a userperforms selections.

Other input into the processor 1302 is provided by sensors 1326. Thesensors 1326 includes a pressure sensor that is sensitive to thepressure within a reservoir of insulin; a cartridge sensor that issensitive to the presence of an insulin cartridge, or a motion sensorthat detects the motion of a gear (not shown) in the drive unit 1312.

Although features, elements, and functions are described above inparticular combinations, a feature, element, or function is used aloneor in any combination with the other features, elements, or functions.Various presently unforeseen or unanticipated alternatives,modifications, variations, or improvements may be subsequently made thatare also intended to be encompassed by the following claims.

The methods described herein are implemented in a computer program,software, or firmware incorporated in a computer-readable medium forexecution by a computer or processor. Examples of computer-readablemedia include electronic signals (transmitted over wired or wirelessconnections) and computer-readable storage media. Examples ofcomputer-readable storage media include, but are not limited to, a readonly memory (ROM), a random-access memory (RAM), removable disks, andoptical media such as CD-ROM disks, and digital versatile disks (DVDs).

What is claimed is:
 1. A method comprising: detecting a triggering eventfor communicating a diabetes-related alert to a user; estimating ahearing ability associated with the user based on user-specificcriteria, wherein the user-specific criteria comprise at least one of anage or a gender of the user; identifying a predefined volume level basedon the estimated hearing ability associated with the user; testing, viaa mobile device associated with the user, a volume level of ambientnoise in a user environment associated with the user; determining, basedon the estimated hearing ability, that the predefined volume level ishigher than the volume level of the ambient noise in the userenvironment; communicating, via an audible alert on the mobile device,the diabetes-related alert to the user at a volume level that is apredefined amount above the higher of the volume level of the ambientnoise and the predefined volume level; and increasing the volume levelof the diabetes-related alert by a predefined volume increase adjustmentin response to a failure of the mobile device to receive a useracknowledgement of the diabetes-related alert after a predefined periodof time.
 2. The method of claim 1, wherein the predefined amount abovethe ambient noise and the predefined volume level is about 0.2-0.4 dB.3. The method of claim 2, the method further comprising: receiving anindication that the mobile device is in a sleep mode; and communicating,via the audible alert on the mobile device, the diabetes-related alertto the user at a volume level that is about 15 dBA above average ambientsound levels during the sleep mode.
 4. The method of claim 1, furthercomprising: confirming the age associated with the user from anapplication on a mobile device, a social media profile, or an indicationfrom the user.
 5. The method of claim 1, further comprising: comparingat least one image of the user stored on the mobile device with imagesof other people of a predefined age or gender; and setting the at leastone of the age or the gender of the user in response to a thresholdlevel of similar features being detected between the at least one imageof the user and the images of the other people having the predefined ageor gender.
 6. The method of claim 1, wherein the user-specific criteriafurther comprises a hearing impairment of the user or an absolutehearing threshold based on responses by the user to a hearing thresholdtest administered by the mobile device using alarm sounds.
 7. The methodof claim 6, wherein the absolute hearing threshold is used to confirmthe predefined volume level when the predefined volume level is based onan estimation of the at least one of the age or the gender, or when theat least one of the age or the gender is unable to be determined.
 8. Themethod of claim 1, further comprising: communicating thediabetes-related alert via an external source to the mobile device inresponse to the mobile device failing to receive the useracknowledgement of the diabetes-related alert and the volume level beingincreased to a predefined maximum volume level, wherein thediabetes-related alert is communicated from the mobile device to theexternal source by performing at least one of the following: sending afirst predefined message for the diabetes-related alert to an externalspeaker device for audible communication to an occupant of a space;sending a second predefined message for the diabetes-related alert viatelecommunication or text message to an alternate device to the mobiledevice; or sending an alert message to control a home automation systemto alert the user.
 9. The method of claim 1, wherein the volume levelcontinues to be increased until a predefined maximum volume level inresponse to the mobile device failing to receive the useracknowledgement of the diabetes-related alert.
 10. The method of claim9, further comprising: receiving an indication from a second userassociated with a health care provider to disable a change to control ofthe volume level by the user; and disabling an ability of the user toprevent the volume level to continue to increase in response to themobile device failing to receive the user acknowledgement of thediabetes-related alert.
 11. The method of claim 1, wherein thepredefined volume increase adjustment comprises a just noticeabledifference (JND).
 12. An apparatus comprising: a speaker; and aprocessor configured to: detect a triggering event for communicating adiabetes-related alert to a user; estimate a hearing ability associatedwith the user based on user-specific criteria, wherein the user-specificcriteria comprise at least one of an age or a gender of the user;identify a predefined volume level based on the estimated hearingability associated with the user; test a volume level of ambient noisein a user environment; determine, based on the estimated hearingability, that the predefined volume level is higher than the volumelevel of the ambient noise in the user environment; communicate, via anaudible alert from the speaker, the diabetes-related alert to the userat a volume level that is a predefined amount above the higher of thevolume level of the ambient noise and the predefined volume level; andincrease the volume level of the diabetes-related alert by a predefinedvolume increase adjustment in response to a failure to receive a useracknowledgement of the diabetes-related alert after a predefined periodof time.
 13. The apparatus of claim 12, further comprising a memory, andwherein the processor is further configured to: compare at least oneimage of the user stored in the memory with images of other people of apredefined age or gender; and set the at least one of an age or thegender of the user in response to a threshold level of similar featuresbeing detected between the at least one image of the user and the imagesof the other people having the predefined age or gender.
 14. Theapparatus of of claim 12, wherein the user-specific criteria furthercomprises a hearing impairment of the user or an absolute hearingthreshold based on responses by the user to a hearing threshold testadministered using alarm sounds, wherein the absolute hearing thresholdis configured to confirm the predefined volume level when the predefinedvolume level is based on an estimation of the at least one of the age orthe gender, or when the at least one of the age or the gender is unableto be determined.
 15. The apparatus of claim 12, wherein the processoris further configured to increase the volume level until a predefinedmaximum volume level in response to a failure to receive the useracknowledgement of the diabetes-related alert.
 16. The apparatus ofclaim 12, wherein the predefined volume increase adjustment comprises ajust noticeable difference (JND).
 17. A system comprising: a firstdevice configured to communicate data associated with a blood glucoselevel of a user; a second device configured to: receive the dataassociated with the blood glucose level of the user; detect, based onthe data associated with the blood glucose level of the user, atriggering event for communicating a diabetes-related alert to the user;estimate a hearing ability associated with the user based onuser-specific criteria, wherein the user-specific criteria comprise atleast one of an age or a gender of the user; identify a predefinedvolume level based on the estimated hearing ability associated with theuser; test a volume level of ambient noise in a user environment;determine, based on the estimated hearing ability, that the predefinedvolume level is higher than the volume level of the ambient noise in theuser environment; communicate, via an audible alert from the speaker,the diabetes-related alert to the user at a volume level that is apredefined amount above the higher of the volume level of the ambientnoise and the predefined volume level; and increase the volume level ofthe diabetes-related alert by a predefined volume increase adjustment inresponse to a failure to receive a user acknowledgement of thediabetes-related alert after a predefined period of time.
 18. The systemof claim 17, wherein the second device is further configured to: compareat least one image of the user stored in memory with images of otherpeople of a predefined age or gender; and set the at least one of theage or the gender of the user in response to a threshold level ofsimilar features being detected between the at least one image of theuser and the images of the other people having the predefined age orgender.
 19. The system of claim 17, wherein the user-specific criteriafurther comprises a hearing impairment of the user or an absolutehearing threshold based on responses by the user to a hearing thresholdtest administered using alarm sounds, wherein the absolute hearingthreshold is configured to confirm the predefined volume level when thepredefined volume level is based on an estimation of the at least one ofthe age or the gender, or when the at least one of the age or the genderis unable to be determined.
 20. The system of claim 17, wherein thepredefined volume increase adjustment comprises a just noticeabledifference (JND).